Individual
KAILEY VITALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
830 HARRISON AVE, BOSTON, MA 02118-2905
(617) 414-6788
Mailing address
238 HANOVER ST APT 1, BOSTON, MA 02113-2341
(630) 815-9985
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
77412-SP-SL
MA
Other
Enumeration date
09/25/2019
Last updated
09/25/2019
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